The immunisation coordinator: improving uptake of childhood immunisation.

Attention to local uptake of childhood immunisation is fundamental to the achievement of national targets. The aim of this investigation was to discover whether local interventions by the immunisation coordinator in a district health authority improved uptake. The immunisation coordinator and a public health nurse determined the immunisation uptake in their locality. They made inquiries, and responded to general practitioners and health visitors who asked them to help encourage persistent non-attenders to consent to immunisation. All interventions intended to encourage parents to consent to immunisation (such as telephone calls, letters, and home visits), and their outcomes, were monitored. The uptake of immunisation was remeasured after one year. Ninety-three children were identified whose parents had not responded to repeated invitations for immunisation. Eleven cases were lost to follow up: the families of 10 children had moved out of the area, and one child had died. The remaining 82 children could be divided into two groups: one group, of 49 children, was due for primary vaccination (diphtheria, tetanus, pertussis, and polio, and measles, mumps, and rubella), and a second group, of 33 children, was due for the preschool (diphtheria, tetanus, and polio) booster. Fifty-eight of the 82 children were vaccinated as a result of the intervention. All but two general practices achieved the 90% target for uptake. The review showed that the locality as a whole achieved greater vaccine coverage. The biggest improvement was in the preschool booster uptake, which rose from 87% to 90%.